Clinical question 1: What is the appropriate use of immune checkpoint blockade in patients with NSCLC?

Over half of patients newly diagnosed in the U.S. with NSCLC present with advanced disease that has already metastasized [2]. At this stage, there have historically been no curative treatment options and few patients (< 5%) survived five or more years [2]. However, there are several treatment options available that can prolong survival in patients with metastatic disease. The Task Force considered the following immunotherapy options for patients with advanced disease: pembrolizumab as a single agent in the first-line setting; nivolumab, pembrolizumab, or atezolizumab in the second-line setting; pembrolizumab in combination with carboplatin and pemetrexed in the first-line setting; and durvalumab in the maintenance/adjuvant setting. Additionally, the Task Force considered durvalumab following chemoradiation in patients with locally, advanced disease.